Hyperici herba

Dried flowering shoot tips, flowers, leaves and stems of St. John's wort. see also under Hypericum perforatum

Quality is defined in the European Pharmacopoeia (Ph. Eur.).

HMPC monograph: Well-established use: Mild and moderate depression. Traditional-use: Relief of temporary mental exhaustion, mild gastrointestinal complaints External: Mild skin inflammations such as sunburn, minor wounds.

ESCOP monograph: internal: dry extracts with ethanol (50-68%) mild depressive episodes; dry extracts with ethanol or methanol 80%: mild to moderate depressive episodes
Powder, dry extracts 4-7:1, ethanol 35%, various liquid extracts, tinctures and a fresh plant pressed juice: temporary mental exhaustion. Powder, cut drug: mild gastrointestinal complaints. External: mild skin inflammations, small wounds.

Dermatitis solaris: Oleum Hyperici (St. John's wort oil), also known as red oil, is used as a wound healing agent for 1st degree burns and dermatitis solaris. It is also used as an oil or ointment to treat chapped skin or old scars, torn muscles and bruises.

Commission E-monograph: internal: Psychovegetative disorders, depressive moods, anxiety and/or nervous restlessness;

oily St. John's wort preparations: dyspeptic complaints; post-treatment of injuries, myalgia (muscle pain), 1st degree burns.

Empirical medicine: irritable bladder, enuresis nocturna, gastritis, gallbladder inflammation, poorly healing infected wounds, ulcus cruris as an oily preparation.

Ingredients: hypericins (naphthodianthrones), hyperforin (phloroglucin derivative), flavonoids and biflavones.

Externally, hyperforin has antibacterial, antiviral, anti-inflammatory and differentiation-promoting effects. Atopic eczema: Studies showed in a randomized, double-blind, placebo-controlled study in a half-side trial (only 21 patients) a significant superiority for the externally applied St. John's wort in a 1.5 % cream compared to the vehicle (Schempp CM et al. 2003).

Internal: Mood-enhancing, antidepressant and anxiolytic. Inhibition of synaptosomal uptake of serotonin, noradrenaline, GABA and glutamate. ß-down regulation of 5 HAT2-UP regulation (histone acetyltransferase subtype)

External: The various forms of application have anti-inflammatory, antioxidant, antibacterial and antiviral effects. The tannins contained have an astringent effect. Furthermore, the extract appears to have a stimulating effect in keratinocyte cultures. The different effects require further differentiated investigations.

In addition to the above indications, used as Hypericum oil for the treatment of wounds and burns. Hyperforin-rich ointment, 1.5% hyperforin for the treatment of atopic dermatitis.

Phototoxic reactions, gastrointestinal complaints, allergic reactions, fatigue, restlessness.

Hypericum dry extract induces the activity of CYP3A4, CYP2C9, CYP2C19 and P-glycoprotein.

Concomitant use of ciclosporin, tacrolimus for systemic use, amprenavir, indinavir and other protease inhibitors, irinotecan and warfarin is contraindicated.

Caution with simultaneous use of amitriptyline, fexofenadine, benzodiazepines, methadone, simvastatin, digoxin, finasteride! Reduction in plasma concentrations possible.

Reduction in plasma concentrations of oral contraceptives!

Check for possible interactions with necessary anesthetics before elective surgery

Cave Combination with antidepressants (e.g. sertraline, paroxetine, nefazodone), buspirone or with triptans-

Systemic: Children < 12 yrs. Known photosensitivity, major depressive episodes, concomitant use of ciclosporin A, tacrolimus, et al, protease inhibitors in HIV treatment, imatinib, et al, cytostatics, antidepressants (see also use of coumarin-type anticoagulants).

Not recommended in pregnancy and lactation due to lack of data.

Simultaneous use of monoamine oxidase inhibitors and selective serotonin reuptake inhibitors should be avoided!

Internal: e.g. ^Laif® 900 film-coated tablets,

^Jarsin® Tabl. 300-750, St. John's wort-ratiopharm®, Rhoival® tea.

Externally: ^Bedan® as a cream, from the 6th month of life. According to the manufacturer, no increase in photosensitivity.

^{Arthrodynat®} ointment, ^Befelka® oil, ^Buenoson® N ointment, ^Dolo-cyl® oil - muscle and joint oil, ^Kytta ointment®, Phönox Kalophön ointment, Kytta ointment®, Phönox Kalophön ointment, ^Rhoival® tea

Phototoxic! Caution in the summer months, no UV exposure! Duration of action: 2-3 weeks!

St. John's wort has been shown to inhibit Cyp3A4 (see cytochrome P450 enzymes below). This leads to its substrates being broken down more slowly (prolongation of efficacy). Phototoxic! Caution in the summer months, no UV exposure! 2-3 weeks of effect!

1. Wenigmann M. (2017) Phytotherapy medicinal drugs, phytopharmaceuticals, application. Urban & Fischer, pp. 134-135
2. https://www.ema.europa.eu/en/documents/herbal-monograph/final-community-herbal-monograph-hypericum-perforatum-l-herba-well-established-medicinal-use_en.pdf
3. https://arzneipflanzenlexikon.info/johanniskraut.php
4. Miller LG (1998) Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions. Arch Intern Med. 9;158(20):2200-2211. doi: 10.1001/archinte.158.20.2200. PMID: 9818800
5. Schempp et al. (2003) Treatment of subacute atopic dermatitis with St. John's wort cream. Eine randomisierte, placebokontrollierte Doppelblindstudie im Halbseitendesign [Topical treatment of atopic dermatitis with Hypericum cream. A randomized, placebo-controlled, double-blind half-side comparison study]. Hautarzt. 54:248-253. doi: 10.1007/s00105-002-0440-y. PMID: 12634994.
6. Schempp CM et al. (2002) St. John's wort (Hypericum perforatum L.). Eine Pflanze mit Relevanz für die Dermatologie [St. John's wort (Hypericum perforatum L.). A plant with relevance for dermatology]. Hautarzt. 53:316-321. doi: 10.1007/s00105-001-0317-5. PMID: 12063742.
7. Blaschek W (2015) Wichtl tea drugs and phytopharmaceuticals. A handbook for practice. Wissenschaftliche Verlagsgesellschaft Munich. S 342-345
8. Apaydin EA et al.(2016) A systematic review of St. John's wort for major depressive disorder. Syst Rev 5:148.
9. Becker LC et al. (2014) Amended safety assessment of Hypericum perforatum-derived ingredients as used in cosmetics. Int J Toxicol. 33(3 Suppl):5S-23S
10. Golsch S et al. (1997) Reversible increase of photosensitivity in the UVB range by St. John's wort extract preparations. Dermatologist 48: 249-252
11. Huang LF et al (2014) Hypericin: chemical synthesis and biosynthesis. Chin J Nat Med 12:81-88.
12. Reichling J et al. (2003) St. John's Wort (Hypericum perforatum L.)--multicompound preparations versus single substances. Forsch Komplementarmed Klass Naturheilkd 10(Suppl1): 28-32
13. Saller R et al. (2003) St. John's Wort (Hypericum perforatum): a plurivalent raw material for traditional and modern therapies. Forsch Komplementarmed Klass Naturheilkd 10(Suppl1): 33-40
14. Schempp CM et al. (2003) Randomized, placebo-controlled, double-blind, half-page trial Topical treatment of atopic dermatitis with Hypericum cream. A randomized, placebo-controlled, double-blind half-side comparison study. Dermatologist 54: 248-253
15. Schulz V (2001) Incidence and clinical relevance of the interactions and side effects of Hypericum preparations. Phytomedicine 8:152-160.
16. Wölfle U et al. (20149 Topical application of St. John's wort (Hypericum perforatum). Planta Med 80(2-3):109-120.